Sensitivity Of Combined Detection Research Articles

Methylation of Septin9, SRSF1, and PAX8 in Early Screening of Colorectal Cancer in the Population Undergoing Physical Examinations.

The aim was to investigate the value of blood Septin9, SRSF1, and PAX8 gene methylation detection techniques in early screening of colorectal cancer (CRC). A prospective cohort study enrolled 3,000 participants undergoing routine physical examination at Shizong County People's Hospital Health Management Center from December 2021 through November 2022, including 1,512 males and 1,488 females, ranging in age from 20 to 90 years, with a median age of 49 years. Fresh blood samples were collected and tested for Septin9, SRSF1, and PAX8 gene methylation. Positive or negative results were reported. Colonoscopy was recommended for positive results and telephone follow-up for negative results. A chi-squared test analyzed the positive rate of initial screening, colonoscopy compliance, and the detection rate of colorectal lesions. Finally, combined with the follow-up data, the screening effect of Septin9, SRSF1, and PAX8 methylation detection on CRC was evaluated. Among 3,000 cases, 215 cases were preliminarily positive, with a positive rate of 7.1% (215/3,000). The positive rate of Septin9 gene methylation was the highest (6%, 180/3000), followed by SRSF1 (4.1%, 124/3000) and PAX8 (3.6%, 108/3000). The sensitivity of combined detection of Septin9, SRSF1, and PAX8 methylation in the diagnosis of CRC was higher than that of the three alone, and the specificity, positive predictive value, and negative predictive value of combined detection were higher than that of the single detection of blood Septin9, SRSF1, and PAX8 DNA methylation. In addition, the positive rate of initial screening increased with age (χ2 = 32.135, p < 0.001). A total of 150 cases underwent further colonoscopy, and the colonoscopy compliance rate was 69.8% (150/215). Among 150 cases who completed colonoscopy, 5 cases of CRC (3.4%), 25 cases of advanced adenoma (16.0%), 78 cases of non-advanced adenoma (52.0%), and 24 cases of non-adenomatous polyps (22.7%) were detected. The positive predictive value of Septin9, SRSF1, and PAX8 methylation was 94% (141/150) for all colorectal lesions, and 70.0% (105/150) for colorectal cancer and precancerous lesions. Blood Septin9, SRSF1, and PAX8 gene methylation detection, combined with colonoscopy, can effectively detect colorectal cancer and precancerous lesions. This strategy may be an effective way to carry out large-scale colorectal cancer screening in the general risk population. Combined detection of the three genes can improve the detection rate of colorectal cancer, but Septin9 methylation is the most sensitive, which can be used for screening and efficacy evaluation of CRC.

Combined detection of SDC2/ADHFE1/PPP2R5C methylation in stool DNA for colorectal cancer screening.

Colorectal cancer (CRC) is a disease of global concern, and its increasing incidence suggests the need for early and accurate diagnosis. The aim of this study was to investigate the value of combined detection of SDC2, ADHFE1 and PPP2R5C gene methylation in stool samples for early CRC screening. Stool samples from patients with CRC (n = 105), advanced adenoma (AA) (n = 54), non-advanced adenoma (NA) (n = 57), hyperplastic or other polyps (HOP) (n = 47) or no evidence of disease (NED) (n = 100) were collected from September 2021 to September 2022. The methylation levels of SDC2, ADHFE1 and PPP2R5C were quantified by quantitative methylation-specific polymerase chain reaction (qMSP), and faecal immunochemical testing (FIT) was performed. The diagnostic value was assessed using reporter operating characteristic (ROC) curve analysis. The sensitivity of combined detection of SDC2/ADHFE1/PPP2R5C methylation in predicting CRC (0-IV) was 84.8%, the specificity was 98.0%, and the AUC was 0.930 (95% CI 0.889-0.970). Compared to FIT and serum tumour biomarkers, it showed better diagnostic performance for different stages of CRC. The results of this study verified that the methylation levels of SDC2, ADHFE1 and PPP2R5C in stool DNA were significantly increased in CRC patients. Combined detection of SDC2/ADHFE1/PPP2R5C methylation is a potential non-invasive diagnostic method for CRC and precancerous lesion screening. Chinese Clinical Trials Registry, ChiCTR2100046662, registered on 26 May 2021, prospective registration.

Application value of combined detection of serum IL-6, SDF-1 and CD64 in the diagnosis of early postoperative infection after limb fractures

ABSTRACT Objective. To explore the application value of combined detection of serum interleukin-6 (IL-6), stromal cell-derived factor-1 (SDF-1) and neutrophils CD64 (CD64) in the diagnosis of early postoperative infection after limb fractures. Methods. 419 patients with limb fractures un erwent surgical treatment in our hospital were selected as study subjects, and they were divided into infection group (n = 104) and non-infection group (n = 315) according to postoperative pathological results of puncture to detect the levels of serum IL-6, SDF-1 and CD64 in the two groups on the 1st, 3rd, 5th and 7th day after surgery, and to analyze the clinical diagnostic efficacy of single and combined detection of the three indexes in early postoperative infection after limb fractures by ROC curve. Results. The levels of serum IL-6, SDF-1 and CD64 in infection group were overtly higher than those in non-infection group at different time after surgery (P < 0.05), and the AUC value, specificity and sensitivity of combined detection were higher than those of single diagnosis. In this study, 14 patients in infection group underwent reoperation, 22 patients received conservative treatment in the later period, 6 patients had postoperative muscular dystrophy, and the remaining patients had a good prognosis. Conclusion. Serum IL-6, SDF-1 and CD64 are closely related to the occurrence of early postoperative infection after limb fractures, and their combination is helpful to improve diagnostic accuracy of early postoperative infection and provide effective reference value for the treatment of postoperative infection in orthopedics.

Evaluation on Diagnostic Value of Ultrasonic Elastography Parameters and Serum Testosterone in the Diagnosis of Prostate Cancer.

To explore the clinical diagnostic value of ultrasound elastography (UE) combined with serum testosterone (T) detection in prostate cancer (PCa). A total of 155 patients with suspected PCa admitted to Affiliated Qingdao Third People's Hospital from January 2020 to January 2022 were included in this study. All the patients underwent UE detection and serum T examination and were divided into positive and negative groups based on histopathological examination results. The detection rates of UE detection, serum T detection and combined detection of the two were compared. T test, nonparametric test and binary logistic regression were used for statistical analysis. The diagnostic efficiencies of single and combined detection were analysed using the receiver operating characteristic (ROC) curve. After the pathological confirmation, 71 cases were classified under the positive group and 84 cases in the negative group. The positive group had significantly higher elastic strain ratio and elastic-image compression index level and a significantly lower serum T level than the negative group (p < 0.05). Elastic strain ratio, elastic image compression index and serum T level were all risk factors for PCa (p < 0.05). ROC analysis showed that the sensitivity of combined detection was significantly higher than that of single detection. Offering a certain clinical application value, the application of combined UE and serum T detection in the clinical diagnosis of PCa can compensate for the shortcomings of single diagnosis, improve diagnostic sensitivity and accuracy and provide a new direction for the clinical diagnosis of PCa.

Correlation Analysis of CML, sRAGE, and esRAGE and the Measure of Atherosclerosis of Coronary Heart Disease.

Objective To investigate the correlation between CML, sRAGE, and esRAGE and the measure of atherosclerosis of coronary heart disease. Methods From June 2019 to December 2021, there were 100 patients in all suffering from coronary heart disease (CHD) selected as the observation group. On the basis of Gensini score, they were divided into mild group (Gensini score < 12 points), moderate group (12 points ≤ Gensini score ≤60 points), and severe group (Gensini score > 60). Apart from that, 50 normal people staying in our hospital for physical examination were chosen as the control group in the meantime. N in each group was detected and compared ε-Carboxymethyl lysine (CML), soluble advanced glycation end product receptor (sRAGE), and endogenous secretory advanced glycation end product receptor (esRAGE). Pearson correlation coefficient was adapted to assay the relevance between CML, sRAGE, and esRAGE, as well as the degree of atherosclerosis in CHD. Receiver operator characteristic (ROC) curve was applied to during the evaluation of the diagnosis of CML, sRAGE, and esRAGE, as well as their combined detection of severe atherosclerosis in CHD. Results In contrast with the control group, the level of serum CML together with sRAGE in the observation group was considerably elevated, while the level of esRAGE appeared in a downward trend (P < 0.05). The level of serum CML and sRAGE was directly proportional to the measure of atherosclerosis in CHD, while the level of esRAGE was inversely proportional to the measure of atherosclerosis in CHD (P < 0.05). That is to say that serum CML and sRAGE were positive in matter of the measure of atherosclerosis in CHD, while esRAGE negatively appertains to the measure of atherosclerosis in CHD (P < 0.05). Serum CML, sRAGE, and esRAGE could effectively diagnose severe atherosclerosis in CHD, and the combined detection sensitivity (89.79%), specificity (77.16%), accuracy (86.12%), positive predictive value (86.63%), negative predictive value (88.59%), and area under ROC curve (AUC) (0.924) were higher (P < 0.05). Conclusion CML and sRAGE, as well as esRAGE, are bound up with the degree of atherosclerosis in CHD, which is conducive to clinical diagnosis and treatment.

Association of multiple tumor markers with newly diagnosed gastric cancer patients: a retrospective study.

BackgroundThe purpose of this paper was to explore the correlation between multiple tumor markers and newly diagnosed gastric cancer.MethodsWe selected 268 newly diagnosed patients with gastric cancer and 209 healthy subjects for correlation research. The detection of multiple tumor markers was based on protein chips and the results were statistically analyzed using SPSS.ResultsWe concluded that gastric cancer was significantly related to gender, age, alpha fetoprotein (AFP), carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), carbohydrate antigen 199 (CA199), and carbohydrate antigen 242 (CA242) positive levels (P < 0.001). After CA199 and CA242 were stratified by gender, the male odds ratio (OR) was 30.400 and 31.242, respectively, while the female OR was 3.424. After CA125 was stratified by age in patients over 54 years old with gastric cancer, the risk of occurrence in the CA125-positive population was 16.673 times that of the CA125-negative patients. Among patients 54 years old and younger, being CA125-positive was not a risk factor for gastric cancer (P = 0.082). AFP, CEA, CA125, CA199, and CA242 positive levels during the M1 stage were statistically significant when compared with the M0 stage and control group (P < 0.001), but the AFP (P = 0.045) and CA125 (P = 0.752) positive levels were not statistically significant when compared with the M0 stage and control group. The combined detection sensitivity of multiple tumor markers was 44.78%.ConclusionOur research shows that gastric cancer is associated with age, gender, and the positive levels of AFP, CEA, CA125, CA199, and CA242. The positive levels of AFP and CA125 were related to the distant metastasis of gastric cancer. To a certain extent, the combined detection sensitivity can be used for the initial screening of gastric cancer.

Noninvasive Detection of Esophageal Cancer by the Combination of mSEPT9 and SNCG.

Background: Esophageal cancer (EC) is the second most common malignant tumor of the digestive system. There is currently no effective noninvasive method for early detection of EC. Methods: We performed a prospective cohort study involving 188 EC patients, 125 patients with benign esophageal diseases, and 270 normal subjects to examine the performance of methylated SEPT9 (mSEPT9) and synuclein gamma (SNCG) individually and in combination. Results: The sensitivity of mSEPT9 and SNCG for EC was 43.1% (AUC = 0.69) at 95.6% specificity and 41.8% (AUC = 0.79) at 92.6% specificity, respectively. The combined detection increased the sensitivity to 71.8% at 90.3% specificity. The combined detection sensitivity for stage I-IV EC was 66.7%, 58.3%, 75.0%, and 88.2%, respectively. No significant difference in combined sensitivity was found among patients with EC of the upper, middle, and lower esophagus, and no significant difference in sensitivity was found between adenocarcinoma and squamous carcinoma. The sensitivity of highly differentiated EC was found to be higher than that of moderately and poorly differentiated EC with SNCG and combined detection. The sensitivity of SNCG in female patients was significantly higher than that in male patients, leading to the same trend in combined detection. Patients aged 40-49 years showed higher combined sensitivity. The sensitivity of SNCG was much higher than that of existing protein markers for digestive cancers. Furthermore, mSEPT9 was capable of predicting the long-term survival of EC patients with a hazard ratio of 2.65. Conclusion: The combined sensitivity of mSEPT7 and SNGG provided significant improvement over any single biomarker for the early detection of EC. mSEPT7 may be useful as a prognostic marker for long-term survival.

Seven tumor-associated autoantibodies as a serum biomarker for primary screening of early-stage non-small cell lung cancer.

ObjectiveThe purpose of this study was to analyze the levels of tumor‐associated autoantibodies (TAAbs) in lung diseases and determine their diagnostic efficiency in early‐stage non‐small cell lung cancer (NSCLC).MethodsWe retrospectively analyzed the levels of 7‐TAAbs in 177 newly diagnosed early‐stage NSCLC patients, 202 patients with lung benign diseases and 137 healthy cases. The levels of a panel of 7‐TAAbs, including p53, GAGE7, PGP9.5, CAGE, MAGE A1, SOX2, GBU4‐5, were measured by ELISA.ResultsThe serum levels of p53, GAGE7, PGP9.5, CAGE, MAGE A1, SOX2, and GBU4‐5 were not statistically different among NSCLC, benign and healthy groups (p > 0.05). The area under the curve (AUC) of 7‐TAAbs was all lower than 0.70. The sensitivity of combined detection was the highest (23.73%), while the specificity was the lowest (88.79%). The positive rates of PGP9.5, SOX2, and combined detection were significantly different among the three groups (p < 0.05). Among them, PGP9.5 and combined detection were significantly different between the NSCLC and benign groups (p < 0.05), PGP9.5, SOX2 and combined detection were significantly different between the NSCLC and healthy groups (p < 0.05).ConclusionsThe diagnostic efficiency of 7‐TAAbs in early‐stage NSCLC was not high, so it cannot be used alone as a screening method for NSCLC.

[Clinical application of mCIM and eCIM combined detection of carbapenemase-producing enterobacteriaceae].

Objective: To explore the clinical application value of modified carbapenem inactivation test (mCIM) combined with EDTA-modified carbapenem inactivation test (eCIM) for detecting the carbapenemase of CRE isolated from infected patients in clinical diagnosis and infection control of CRE infection. Methods: Drug resistance of seventy eight non-repetitive enterobacteriaceae resistant to carbapenem antibiotics, which were isolated from clinically infected patients from January 2017 to December 2017 in the Tianjin Medical University General Hospital, was retrospectively analyzed. Meanwhile, Vitek2 Compact automatic bacterial identification instrument was used to identify the species and detect its minimum inhibitory concentration (MIC) for ertapenem and imipenem. Carbapenemase genes blaKPC, blaNDM, blaIMP and blaVIM were detected by PCR test, the genotype was determined by gene sequencing as the gold standard, and mCIM Combined eCIM test was used for carbapenemase detection of collected bacteria. Using PCR results as the standard, the sensitivity, specificity, positive predictive value, negative predictive value and Cohen' Kappa value of mCIM and eCIM were calculated, and the consistency of the combined detection results of mCIM and eCIM and PCR results was checked. Results: Seventy eight carbapenem-resistant Enterobacteriaceae were detected by PCR, 74 carbapenemase gene positive and 4 negative, including 60 blaKPC-2 positive, 2 blaNDM-1 positive and blaNDM-5 positive Of the 7 strains, 3 strains were positive for blaNDM-9, 1 strain was positive for blaIMP-4, and 1 strain was both positive for blaKPC-2 and blaNDM-1. The sensitivity of mCIM to detect carbapenemase is 100%, the specificity is 100%, and the Kappa value is 1.000; the combined detection of mCIM and eCIM for serine carbapenemase has a sensitivity of 100%, the specificity is 100%, and the Kappa value is 1.000; The sensitivity of combined detection of metallo-β-lactamase is 92.9%, the specificity is 100%, and the Kappa value is 0.955. Conclusions: The combined test of mCIM and eCIM which is used to detect carbapenemase in CRE costs low, doesn't require special reagents and equipment, has strong practicability, simple operation, and easy interpretation of results. According to the different genotypes of CRE bacteria, it provides important clinical diagnostic evidence for clinical CRE diagnosis, precise antimicrobial treatment and infection control.

Value of miR-1271 and glypican-3 in evaluating the prognosis of patients with hepatocellular carcinoma after transcatheter arterial chemoembolization.

BACKGROUNDHepatocellular carcinoma (HCC) is the third leading cause of cancer death, causing about 750000 deaths worldwide every year. Patients with advanced hepatocellular carcinoma will often only receive transcatheter arterial chemoembolization (TACE). Glypican-3 (GPC3) is one of the most promising serum markers for HCC. Abnormal expression of miRNAs may be involved in the occurrence and development of tumor.AIMTo explore the value of miR-1271 and GPC3 in evaluating the prognosis of patients with HCC after TACE.METHODSFrom January 2016 to December 2018, 162 patients with advanced HCC who received TACE in our hospital were selected into the cancer group, and 162 patients who underwent physical examination during the same period were selected into the health group. The patients in the HCC group were treated with TACE. The changes of serum GPC3 and circulating miR-1271 in the HCC before and after TACE were analyzed. The expression of serum GPC3 was detected by enzyme-linked immunosorbent assay, and the expression of circulating miR-1271 was detected by real-time quantitative polymerase chain reaction. The methodological results of sensitivity, specificity, and accuracy of miR-1271 and GPC3 alone and joint detection of HCC were also evaluated.RESULTSThe level of serum GPC3 in patients with HCC was significantly higher than that in healthy controls. GPC3 levels were increased in both HCC patients and those treated with TACE compared with healthy controls. After TACE, the level of serum GPC3 was significantly lower than that before treatment (P < 0.05), and the level of circulating miR-1271 was significantly higher than that before treatment (P < 0.05). There were 112 cases (69.14%) with remission (complete remission + complete remission + stable disease) and 50 cases (30.86%) with relapse disease progression in HCC patients. After TACE, the miR-1271 level in patients with remission and relapse was lower than that in the healthy group, and the GPC3 level was higher than that in the healthy group, the differences were statistically significant (P < 0.05). The miR-1271 of relapsed patients was lower than that of remission patients, and the level of GPC3 was higher than that of remission patients, and the difference was statistically significant (P < 0.05). The sensitivity of combined detection of miR-1271 and GPC3 was significantly higher than that of single detection, and the difference was statistically significant (P < 0.05); while the specificity of the two combined detections was lower than that of the single detection; and the accuracy was slightly higher than that of single detection, but the difference was not statistically significant.CONCLUSIONThe level of miR-1271 in patients with HCC was significantly increased and the level of GPC3 was decreased after TACE. Monitoring the levels of serum GPC3 and circulating miR-1271 has important clinical reference value for evaluating the prognosis of patients with HCC. The levels of serum GPC3 and circulating miR-1271 may help to determine tumor recurrence, evaluate survival status, and guide the next step of treatment.

Application of 3D-FS-SPGR imaging combined synovial fluid GGCX detection in the evaluation of knee osteoarthritis.

Osteoarthritis represents a kind of chronic and degenerative joint disease characterized by articular cartilage injury and osteoproliferation. Osteoarthritis especially poses a serious threat to the elderly patients. At present, the diagnosis of osteoarthritis mainly consists of clinical examination, X-ray examination, magnetic resonance imaging (MRI), and arthroscopy. However, limitations and misdiagnosis are found within the single method. This article intends to investigate the feasibility of assessing the condition of knee osteoarthritis through quantitative analysis of cartilage using nuclear magnetic resonance 3D fast-spin spoiled gradient-recalled echo (NMR 3D-FS-SPGR) imaging and γ-glutamic acid carboxylase (GGCX) detection in synovial fluid. A total of 60 patients with primary knee osteoarthritis were enrolled. All the patients were staged and received 3D-FS-SPGR sequence MRI scan for grading based on scan results and cartilage injury. Cartilage tissues were collected for immunohistochemistry (IHC). The GGCX in cartilage was detected using western blotting to analyze the correlation with arthritis. The condition of articular cartilage injury in arthritis patients was clearly observed using 3D-FS-SPGR sequence. The expression of GGCX was decreased in 46 patients (p < 0.05). The expression of GGCX in synovial fluid was significantly reduced following upstaging (p < 0.05). The sensitivity measured using combined 3D-FS-SPGR imaging and synovial fluid GGCX detection for the evaluation of arthritis condition was significantly higher than that of the single detection method (p < 0.05). Our data showed that the sensitivity of combined detection was obviously higher than single detection for the evaluation of arthritis. The 3D-FS-SPGR combined with synovial fluid GGCX detection could be treated as a promising strategy for arthritis evaluation.

Clinical value of combined detection of reactive oxygen species modulator 1 and adenosine deaminase in pleural effusion in the identification of NSCLC associated malignant pleural effusion.

BackgroundReactive oxygen species modulator 1 (ROMO1) is recognized to be involved in cell proliferation and is elevated in serum of various cancer patients. However, ROMO1 had little research in distinguishing between malignant pleural effusions (MPEs) and benign pleural effusions (BPEs).MethodsMalignant pleural effusion samples from patients with non–small‐cell lung cancer (NSCLC) and benign pleural effusion (BPE) samples containing tuberculous and inflammatory pleural effusions were collected. The samples were tested for ROMO1, pleural effusion adenosine deaminase (pADA), pleural effusion carbohydrate antigen (pCA125, pCA153, pCA199), pleural effusion ferritin (pFER), and pleural effusion lactate dehydrogenase (pLDH) levels, and the other relevant partial clinical data that were gathered were used to conduct statistical analysis.ResultsThe ROMO1, pCA125, pCA199, pCA153, pADA + ROMO1, pCA153 + ROMO1, pCA125 + ROMO1, and pCA199 + ROMO1 levels in MPE were appreciably higher in comparison with BPE group (all P = .000). The concentration of pADA in MPE was markedly lower than BPE (P = .000). When the cutoff = 0.38, the sensitivity of combined detection of ROMO1 + pADA is 98.67% and the specificity is 70.73%, respectively, and the AUC (0.941) is the highest among other parameters.ConclusionThe combined detection of ROMO1 + ADA in pleural effusion is an effective biomarker for identifying MPE caused by NSCLC.

Expressions of osteopontin, matrix metalloproteinase 2 and vascular endothelial growth factor in gastric cancer and their prognostic value

Objective To investigate the relationship between the expressions of osteopontin (OPN), matrix metalloproteinase 2 (MMP-2) and vascular endothelial growth factor (VEGF) in gastric cancer and the poor prognosis of gastric cancer patients. Methods A total of 35 patients with gastric cancer after radical gastrectomy from January 2014 to March 2015 in Dalian Third People's Hospital were retrospectively analyzed. The expressions of OPN, MMP-2 and VEGF in gastric cancer tissues and adjacent normal tissues were detected by immunohistochemical SP staining. The relationship between the expressions of OPN, MMP-2 and VEGF and the poor prognosis of gastric cancer patients was analyzed. Results The positive expression rates of OPN, MMP-2 and VEGF in postoperative pathological tissues of gastric cancer were 80.0% (28/35), 77.1% (27/31) and 88.6% (31/35), respectively. OPN expression was associated with vascular invasion, lymph node metastasis, degree of differentiation, degree of invasion, and Lauren classification (all P < 0.05). MMP-2 expression was associated with vascular invasion, lymph node metastasis, and degree of invasion (all P < 0.05). VEGF expression was associated with vascular invasion, lymph node metastasis, degree of invasion, and Lauren classification (all P < 0.05). OPN, VEGF and MMP-2 had synergistic effects in the invasion and metastasis of gastric cancer, and the expressions of them were positively correlated (all P < 0.05). The sensitivity of combined detection of OPN, VEGF and MMP-2 (87.5%) was higher than the sensitivity of individual detection (68.8%, 62.5% and 56.3%) (P < 0.05). Conclusions OPN, MMP-2 and VEGF expressions are closely related to the poor prognosis of gastric cancer patients, and have synergistic effects in the invasion and metastasis of gastric cancer. The combined detection of OPN, MMP-2 and VEGF may have a more accurate prediction of the prognosis of gastric cancer. Key words: Gastric neoplasms; Osteopontin; Matrix metalloproteinase; Vascular endothelial growth factor; Prognosis; Immunohistochemistry

Value of the methylation status of SDC2 and SFRP2 for colorectal cancer screening

Objective To explore the value of methylation of SDC2 and SFRP2 genes promoter in fecal DNA for colorectal cancer (CRC) screening. Methods All stool samples were enrolled from Changhai Hospital of Naval Medical University, the Tenth People′s Hospital of Tongji University and the Seventh Medical Center of Chinese People′s Liberation Army General Hospital. A total of 500 stool samples collected from March 2018 to December 2018 were allocated to CRC group (132 CRCs) , adenoma group (38 advanced adenomas) , healthy group (152 healthy individuals) , interferential group (178 cases of benign colorectal disease or other non-colorectal tumors) and negative group (330 cases composed of healthy group and interferential group) . The promoter methylation of fecal SDC2 and SFRP2 genes was detected by methylation-specific PCR (MSP) and compared with single gene methylation and the fecal immunochemical tests (FIT) to evaluate its sensitivity and specificity. Results The stool sample analysis showed that the sensitivity of combined detection of SDC2 and SFRP2 in CRC group was 97.73% (129/132) , which was significantly higher than those of the single gene SDC2 test [70.45% (93/132) , P=0.000], single SFRP2 test [81.82% (108/132) , P=0.000] and FIT [69.70% (92/132) , P=0.000]. In adenoma group, the sensitivity of combined detection of SDC2 and SFRP2 was 57.89% (22/38) , which was significantly higher than those of the single gene SDC2 test [15.79% (6/38) , P=0.000] and FIT [21.05% (8/38) , P=0.021], with no significant difference compared with that of SFRP2 test [47.37% (18/38) , P=0.358]. In healthy group, the specificity of combined detection of SDC2 and SFRP2 was 98.68% (150/152) , with no significant difference compared with those of single gene SDC2 test [100.00% (152/152) , P=0.156], single SFRP2 test [98.68% (150/152) , P=1.000] or FIT [95.39% (145/152) , P=0.091]. Specificities of combined detection of two genes in interferential and negative groups were 90.45% (161/178) and 94.24% (311/330) , which were significantly higher than 73.03% (130/178, P=0.000) and 83.33% (275/330, P=0.000) of FIT, respectively. Conclusion The combined detection test of methylation of SDC2 and SFRP2 is superior to single gene test, whose sensitivity of CRC and aggressive adenoma and specificity of distinguishing benign and malignant lesions are higher than FIT, which has potential application value. Key words: Gene components; DNA; Feces; Methylation; Colorectal neoplasms; SDC2/SFRP2

Diagnostic value of serum amyloid A and retinol binding protein in patients with early type 2 diabetic kidney disease

Objective To investigate the value of serum amyloid A (SAA) and retinol binding protein (RBP) in diagnosis of early type 2 diabetic kidney disease (DKD). Methods A total of 182 type 2 diabetic patients hospitalized in department of Endocrinology and Nephrology of Lianyungang Second People′s Hospital from January to December 2017 were randomly collected as subjects.According to urinary albumin-creatinine ratio (UACR), all subjects were divided into three groups of normal albuminuria group (NA, 60 cases), microalbuminuria group (MA, 63 cases) and clinical proteinuria (CP, 59 cases). In the same period, 60 healthy persons were selected as normal control (NC). The levels of serum SAA and RBP were detected by automatic biochemical analyzer.Receiver operating curve (ROC) was used to analysis the diagnostic efficiency of DKD and the risk factors of DKD were further estimated. Results The levels of SAA were (6.88±2.82) and (37.21±20.58) mg/L in control group and case group.And levels of serum SAA in the NA group, MA group and CP group were (16.33±5.98), (40.97±15.62), (54.43±22.91) mg/L respectively.The levels of RBP were (37.56±10.51) and (69.26±21.23) mg/L in control group and case group.And levels of RBP in the NA group, MA group and CP group were (52.66±14.31), (69.66±15.52), (85.70±19.51) mg/L respectively.The concentrations of serum SAA and RBP in type 2 diabetic patients were significantly higher than those normal controls (t=10.36, P<0.05; t=11.11, P<0.05) and increased with DKD progression (F=83.6, P<0.05; F=59.2, P<0.05). Diagnostic sensitivity of serum SAA, RBP in DKD was 81.8% and 84.1% respectively.Diagnostic sensitivity of combined detection was 90.9%.Regression analysis showed that SAA, RBP and UACR were independent risk factors for DKD (OR(95%CI)=1.391(1.068-1.812), 1.212(1.085-1.353), 1.148(1.038-1.270); all P<0.05). Conclusion Both of serum SAA and RBP were significantly elevated in diabetic patients with renal injury so that they had great value in early diagnosis of DKD. Key words: Amyloid A; Retinol binding protein; Diabetic nephropathy; Urinary microalbumin; Urinary creatinine

Value of combined detection of serum carcino-embryonic antigen, carbohydrate antigen 19-9 and cyclooxygenase-2 in the diagnosis of colorectal cancer.

The aim of the present study was to investigate the value of combined detection of serum carcino-embryonic antigen (CEA), carbohydrate antigen (CA) 19-9 and cyclooxygenase-2 (COX-2) in the diagnosis of colorectal cancer. A total of 50 patients with colorectal cancer were selected as Group A and 50 healthy subjects as the control group. A sample of 2 ml fasting venous blood was drawn from patients in each group, and serum CEA, CA19-9 and COX-2 were detected using electrochemiluminescence analyzer and ELISA. Receiver operating characteristic curve analysis was performed on analyze the sensitivity and specificity of diagnostic methods for colorectal cancer patients at different stages. The expression levels of CEA, CA199 and COX-2 in the cancer patients group were significantly higher than those in the healthy group (P<0.05). The coincidence rates of CEA, CA199, COX-2 and combined detection were 56.0, 64.0, 62.0 and 88.0%, respectively. The coincidence rate of combined detection was significantly higher than that of diagnosis using a single factor (P<0.05). Sensitivity of combined detection of colorectal cancer patients with stage I, II, III and IV were 82.9, 85.3, 86.4 and 88.7%, respectively. The specificities were 65.3, 68.7, 57.8 and 58.6%, respectively. Thus, CEA, CA199 and COX-2 in serum are highly expressed in colorectal cancer patients, and may useful as effective indicators for the early diagnosis of colorectal cancer.

Establishment of cut-off value of serum pro-gastrin-releasing peptide for diagnosis of small cell lung cancer and evaluation on the clinical diagnosis efficiency

Objective: To determine critical reference value (cut-off value) of serum pro-gastrin-releasing peptide (ProGRP) and neuron specific enolase(NSE) in the diagnosis of small cell lung cancer(SCLC). To evaluate the clinical significance of serum levels of ProGRP and NSE in diagnosis and differential diagnosis in SCLC. Methods: Three hundred and fifty-two SCLC patients, 163 non small cell lung cancer(NSCLC)patients , 193 benign pulmonary disease patients and 140 healthy people visiting in National Cancer Hospital were analyzed retrospectively from January 2014 to July 2017.The levels of serum ProGRP and NSE of people were determined using electrochemiluminescent immunoassay respectively . Reference value ranges of the makers were determined by using the method of ROC curves. Results: In NSCLC group, benign lung disease group, healthy control group and mixed group (NSCLC+ lung benign diseases+ healthy control group) as a reference, the cut-off values were 58.3, 62.3, 57.8, 61.3 ng/L. In the diagnosis and differential diagnosis of SCLC and NSCLC, benign lung diseases, healthy controls and mixed group, AUC of ProGRP was 0.940 (0.919-0.961), 0.941 (0.921-0.960), 0.959 (0.944-0.975), 0.946 (0.928-0.963) respectively. The sensitivities of ProGRP were 86.4%, 84.9%, 86.4% and 84.7% respectively. The specificities of ProGRP were 95.7%, 96.9%, 99.3%, 98% respectively. In all groups the Youden's index of ProGRP and NSE were 0.821 vs 0.612, 0.818 vs 0.674, 0.857 vs 0.810, 0.827 vs 0.674. In healthy controls, no statistically significant difference was found between ProGRP and NSE (P>0.05) in the diagnosis of AUC. However, in the remaining 3 groups, the ProGRP diagnosis of AUC was significantly greater than that of NSE (P<0.01). Compared with single marker detection, the sensitivity of combined detection of ProGRP and NSE in diagnosis of SCLC increased to 95.5%, 94%, 96.6% and 94% in each group. There was no significant difference between ProGRP and ProGRP+ NSE in the diagnosis of AUC when compared with the NSCLC group and the mixed group (P>0.05). However, when combined with a healthy control group and a benign lung disease group, the ProGRP+ NSE combination was the highest for AUC diagnosis, compared with ProGRP and NSE (P<0.01). In the SCLC ED group serum ProGRP and NSE levels[776.33(3 103.4)ng/L, 52.14(60.59)μg/L]were higher than those in the SCLC LD group[295.59(799.65)ng/L, 23.36(22.97)μg/L], respectively (all P<0.001). The serum ProGRP levels of N0, N1, N2 and N3 in TNM staging were 113.0(343.65), 167.04(724.56), 427.42(1 388.62), 735.99(1 709.95)ng/L respectively (all P<0.001). Serum ProGRP and NSE levels were not statistically different between the sex groups and the age groups (all P>0.05). Conclusion: To establish the cut-off value of serum ProGRP is helpful for the diagnosis and differential diagnosis of SCLC.

Diagnostic value of combined detection of CA125, HE-4 and D-Dimer in ovarian cancer

Objective To investigate the separate and combined detection value of serum carbohydrate antigen 125 (CA125), human epididymis protein 4 (HE-4) and D dimer (D-dimer) in the diagnosis of ovarian cancer. Methods One hundred and twenty ovarian cancer patients were selected as the observation group, one hundred and twenty patients with ovarian benign tumor as the benign group, eighty women with healthy physical examination results as the control group, then the chemiluminescence immunoassay was used to detect the expression of serum CA125 and HE-4 of the three groups, and the immune turbidimetric method was applied to examine the expression of D-dimer.At last, the diagnosis efficiency of CA125, HE-4 and D-dimer in separate and combined detection was calculated. Results CA125 in the observation group was ( 623.07±274.18) U/ml, HE-4 was (594.22±329.068) ng/ml and D-dimer was (418.57±276.75) ng/L, CA125 in the benign group was (45.09±32.58) U/ml, HE- 4 was (97.92±57.52) ng/ml and D-dimer was (204.52±80.07) ng/L; CA125 in the control group was (40.23±28.16) U/ ml, HE-4 was (85.65±37.27) ng/ml and D-dimer was (187.57±65.74) ng/L, the differences between the three groups were statistically significant (F=122.82, 89.91, 54.46; P<0.05). The level of CA125 in the serum of patients with advanced stage (stage III-IV) was (586.10±278.33) U/ml, HE-4 was (437.49±238.06) ng/ml, D-dimer was (493.78±274.45) ng/L, in the early stage (stage I-II), the level of CA125 in the serum of patients with ovarian cancer was (372.12±265.31) U/ml, HE-4 was (673.64±301.68) ng/ml, D-dimer was (364.84±267.54) ng/L, and the difference was statistically significant ( t=4.244, 4.78, 2.560, P<0.05). The detection sensitivity and specificity of CA-125 were 71.67% and 62.50% respectively.The sensitivity of HE-4 was 74.17% and the specificity was 75.00%.The sensitivity of D-dimer was 62.5% and the specificity was 60.00%.The combined detection sensitivity of the three was 80.00% and the specificity was 77.5%. Conclusion The sensitivity and specificity of the three tumor markers in combined detection were higher than those of separate detections, so the combined detection of CA125, HE-4 and D-dimer can further improve the diagnosis level of ovarian cancer. Key words: Carbohydrate antigen 125; Human epididymal protein 4; D-dimer; Ovarian cancer

Application of molecular, microbiological, and immunological tests for the diagnosis of bone and joint tuberculosis.

To evaluate the application of interferon gamma release assay (IGRA), rifampicin resistant real-time fluorescence quantitative PCR technique Xpert Mycobacterium tuberculosis/rifampicin (Xpert MTB/RIF), and the levels of TNF-α and TGF-β in the diagnosis of bone and joint tuberculosis. Eighty-six patients with bone and joint tuberculosis, diagnosed by pathology or microbiology, were examined by Xpert MTB/RIF and IGRA (T-SPOT. TB) for Mycobacterium tuberculosis infection, and the TNF-α and TGF-β levels of the patients were measured. The sensitivity of IGRA in diagnosing bone and joint tuberculosis was 81.4%; Xpert MTB/RIF's sensitivity was 70.9%. The combined sensitivity of the two methods was 91.9%. The combined detection sensitivity of the two methods was higher than individual IGRA or Xpert MTB/RIF detection sensitivity. The TNF-α and TGF-β levels in bone and joint tuberculosis patients were higher than those in the control group. Xpert MTB/RIF, IGRA, TNF-α, and TGF-βs expression have value in the rapid diagnosis of bone and joint tuberculosis, and the sensitivity and accuracy of bone and joint tuberculosis diagnosis by combining them can improve it.

Clinical Value of Combined Detection of CK-MB, MYO, cTnI and Plasma NT-proBNP in Diagnosis of Acute Myocardial Infarction.

Acute myocardial infarction (AMI) is a serious life-threatening and common heart disease that is based on coronary atherosclerosis. The aim is to study the changes in the level of kinase isoenzyme (CK-MB), myoglobin (MYO), cardiac troponin I (cTnI), and plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with acute myocardial infarction (AMI) and the four indicators of joint detection clinical value for diagnosis of AMI. Plasma NT-proBNP, CK-MB, MYO, and cTnI were detected by CLIA in 208 AMI patients (AMI group) and 115 non-AMI patients (control group). SPSS 19.0 software was used to analyze the data. The concentrations of CK-MB, MYO, cTnI, and NT-proBNP show significant differences between these two groups. In the AMI group, a significantly positive correlation was found between CK-MB and each of MYO and cTnI (r = 0.537, r = 0.226). Meanwhile, the sensitivity of combined detection has been improved up to 92.79%. Therefore, these results suggested that detecting CK-MB, MYO, cTnI, and plasma NT-proBNP levels together can significantly contribute to the early diagnosis of AMI. It can also provide diagnostic evidence to clinic and thus lower the mortality of AMI in acute phase.